EXPRESS DIAGNOSIS OF ZYGOMATICO-ORBITAL COMPLEX FRACTURES USING THE METHOD OF ELECTRODENTODIAGNOSTICS

Abstract

In the treatment of patients with trauma to the zygomaticoorbital complex, the timing of surgical intervention has a great influence on the final outcome of treatment. The main reason for untimely diagnosis is the presence of a concomitant hematoma of the soft tissues of the zygomatic and infraorbital regions, which masks the bone deformation of the zygomatic region. As a rule, 7-10 days after the injury, the hematoma resolves on its own, but the optimal timing for surgical treatment of the fracture has already been lost. Purpose. We set ourselves the task of developing a simple, accessible method for diagnosing a fracture of the zygomatico-orbital complex, which can be used by any general dentist. In addition, the proposed technique allows for differential diagnosis between a fracture and a hematoma of the zygomatic region. Our technique also allows for the diagnosis to use teeth not only on the side of the injury, but also on the healthy side (due to the phenomenon of repercussion). Materials and methods of the study. We examined 63 patients with trauma to the zygomatic complex and 42 patients with isolated soft tissue hematoma of the infraorbital and (or) zygomatic region. The study was conducted using a standard method. The EOM-3 device was used. In both groups, all intact teeth of the upper jaw were examined on both the diseased and healthy sides. Measurements were taken three times in the area of each tooth and the average value was recorded. The obtained data were divided into subgroups according to the tooth number and the number of days since the injury. Dynamic series were formed from these data. The obtained data were processed using the Kolmogorov- Smirnov criterion, regression statistical analysis, and Neumann criterion. Calculations were performed using Microsoft Excel, Math Cad programs. Research results. The result of the work was the receipt of a formula for the functional dependence of the value of tooth sensitivity on the time elapsed since the day of the injury. The general formula of this functional dependence has the form Y=a*x^b*2.718282^(c*x), where Y is the numerical value of the tooth sensitivity on a given day from the day of the injury; a, b, c are the parameters of the equation; x is a variable that specifies the number of days from the day of the injury; 2.718282-i (base of the natural logarithm). The advantage of the selected functional dependence is the change in the configuration of the regression line depending on the magnitude and sign of the equation parameters, which allowed us to quantitatively describe the identified dependences. The work provides formulas for each tooth on the upper jaw on both the healthy side and the side of the injury. They allow to calculate the value of electrical excitability at different times after the injury and thus to conduct an objective diagnosis of a fracture of the zygomatico-orbital complex, as well as differential diagnosis with a hematoma of the zygomatic and infraorbital regions. The method allows to objectively diagnose the presence of a fracture in any dental institution at different times from the moment of injury. Conclusions. A simple, effective, affordable method for diagnosing a fracture of the zygomatico-orbital complex has been developed, which can be used by a dentist in any conditions, does not require expensive equipment, and allows for diagnosis in the presence of secondary defects of the dentition.